Improving Perioperative Outcomes Through Minimally Invasive and Non-invasive Hemodynamic Monitoring Techniques

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2018 Jun 6

PMID 29868596

Citations 8

Authors

Takashige Yamada

Susana Vacas

Yann Gricourt

Maxime Cannesson

Affiliations

Soon will be listed here.

Abstract

An increasing number of patients require precise intraoperative hemodynamic monitoring due to aging and comorbidities. To prevent undesirable outcomes from intraoperative hypotension or hypoperfusion, appropriate threshold settings are required. These setting can vary widely from patient to patient. Goal-directed therapy techniques allow for flow monitoring as the standard for perioperative fluid management. Based on the concept of personalized medicine, individual assessment and treatment are more advantageous than conventional or uniform interventions. The recent development of minimally and noninvasive monitoring devices make it possible to apply detailed control, tracking, and observation of broad patient populations, all while reducing adverse complications. In this manuscript, we review the monitoring features of each device, together with possible advantages and disadvantages of their use in optimizing patient hemodynamic management.

Citing Articles

Management of gastrointestinal bleed in the intensive care setting, an updated literature review.

Nagesh V, Pulipaka S, Bhuju R, Martinez E, Badam S, Nageswaran G World J Crit Care Med. 2025; 14(1):101639.

PMID: 40060732 PMC: 11671843. DOI: 10.5492/wjccm.v14.i1.101639.

Intraoperative Beat-to-Beat Pulse Transit Time (PTT) Monitoring via Non-Invasive Piezoelectric/Piezocapacitive Peripheral Sensors Can Predict Changes in Invasively Acquired Blood Pressure in High-Risk Surgical Patients.

Nordine M, Pille M, Kraemer J, Berger C, Brandhorst P, Kaeferstein P Sensors (Basel). 2023; 23(6).

PMID: 36992016 PMC: 10059272. DOI: 10.3390/s23063304.

A Remote Patient-Monitoring System for Intensive Care Medicine: Mixed Methods Human-Centered Design and Usability Evaluation.

Poncette A, Mosch L, Stablo L, Spies C, Schieler M, Weber-Carstens S JMIR Hum Factors. 2022; 9(1):e30655.

PMID: 35275071 PMC: 8957007. DOI: 10.2196/30655.

Imputation of the continuous arterial line blood pressure waveform from non-invasive measurements using deep learning.

Hill B, Rakocz N, Rudas A, Chiang J, Wang S, Hofer I Sci Rep. 2021; 11(1):15755.

PMID: 34344934 PMC: 8333060. DOI: 10.1038/s41598-021-94913-y.

Does electroencephalographic burst suppression still play a role in the perioperative setting?.

Lobo F, Vacas S, Rossetti A, Robba C, Taccone F Best Pract Res Clin Anaesthesiol. 2021; 35(2):159-169.

PMID: 34030801 PMC: 8330552. DOI: 10.1016/j.bpa.2020.10.007.

References

Mukkamala R, Hahn J, Inan O, Mestha L, Kim C, Toreyin H . Toward Ubiquitous Blood Pressure Monitoring via Pulse Transit Time: Theory and Practice. IEEE Trans Biomed Eng. 2015; 62(8):1879-901. PMC: 4515215. DOI: 10.1109/TBME.2015.2441951. View

Mythen M, Swart M, Acheson N, Crawford R, Jones K, Kuper M . Perioperative fluid management: Consensus statement from the enhanced recovery partnership. Perioper Med (Lond). 2014; 1:2. PMC: 3886264. DOI: 10.1186/2047-0525-1-2. View

Saugel B, Meidert A, Langwieser N, Wagner J, Fassio F, Hapfelmeier A . An autocalibrating algorithm for non-invasive cardiac output determination based on the analysis of an arterial pressure waveform recorded with radial artery applanation tonometry: a proof of concept pilot analysis. J Clin Monit Comput. 2013; 28(4):357-62. DOI: 10.1007/s10877-013-9540-8. View

Jakovljevic D, Trenell M, MacGowan G . Bioimpedance and bioreactance methods for monitoring cardiac output. Best Pract Res Clin Anaesthesiol. 2014; 28(4):381-94. DOI: 10.1016/j.bpa.2014.09.003. View

Cannesson M, Desebbe O, Rosamel P, Delannoy B, Robin J, Bastien O . Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatre. Br J Anaesth. 2008; 101(2):200-6. DOI: 10.1093/bja/aen133. View

Fong T, Tulebaev S, Inouye S . Delirium in elderly adults: diagnosis, prevention and treatment. Nat Rev Neurol. 2009; 5(4):210-20. PMC: 3065676. DOI: 10.1038/nrneurol.2009.24. View

Bijker J, van Klei W, Vergouwe Y, Eleveld D, van Wolfswinkel L, Moons K . Intraoperative hypotension and 1-year mortality after noncardiac surgery. Anesthesiology. 2009; 111(6):1217-26. DOI: 10.1097/ALN.0b013e3181c14930. View

Meidert A, Huber W, Muller J, Schofthaler M, Hapfelmeier A, Langwieser N . Radial artery applanation tonometry for continuous non-invasive arterial pressure monitoring in intensive care unit patients: comparison with invasively assessed radial arterial pressure. Br J Anaesth. 2013; 112(3):521-8. DOI: 10.1093/bja/aet400. View

Odenstedt H, Stenqvist O, Lundin S . Clinical evaluation of a partial CO2 rebreathing technique for cardiac output monitoring in critically ill patients. Acta Anaesthesiol Scand. 2002; 46(2):152-9. View

10.

Vallet B, Blanloeil Y, Cholley B, Orliaguet G, Pierre S, Tavernier B . Guidelines for perioperative haemodynamic optimization. Ann Fr Anesth Reanim. 2013; 32(10):e151-8. DOI: 10.1016/j.annfar.2013.09.010. View

11.

Ameloot K, Van de Vijver K, Van Regenmortel N, De Laet I, Schoonheydt K, Dits H . Validation study of Nexfin® continuous non-invasive blood pressure monitoring in critically ill adult patients. Minerva Anestesiol. 2014; 80(12):1294-301. View

12.

Sessler D, Sigl J, Kelley S, Chamoun N, Manberg P, Saager L . Hospital stay and mortality are increased in patients having a "triple low" of low blood pressure, low bispectral index, and low minimum alveolar concentration of volatile anesthesia. Anesthesiology. 2012; 116(6):1195-203. DOI: 10.1097/ALN.0b013e31825683dc. View

13.

Hahn R, Rinosl H, Neuner M, Kettner S . Clinical validation of a continuous non-invasive haemodynamic monitor (CNAP™ 500) during general anaesthesia. Br J Anaesth. 2012; 108(4):581-5. DOI: 10.1093/bja/aer499. View

14.

Neerland B, Krogseth M, Juliebo V, Ranhoff A, Engedal K, Frihagen F . Perioperative hemodynamics and risk for delirium and new onset dementia in hip fracture patients; A prospective follow-up study. PLoS One. 2017; 12(7):e0180641. PMC: 5503267. DOI: 10.1371/journal.pone.0180641. View

15.

Monk T, Bronsert M, Henderson W, Mangione M, Sum-Ping S, Bentt D . Association between Intraoperative Hypotension and Hypertension and 30-day Postoperative Mortality in Noncardiac Surgery. Anesthesiology. 2015; 123(2):307-19. DOI: 10.1097/ALN.0000000000000756. View

16.

Aloisi F . Immune function of microglia. Glia. 2001; 36(2):165-79. DOI: 10.1002/glia.1106. View

17.

Ilies C, Grudev G, Hedderich J, Renner J, Steinfath M, Bein B . Comparison of a continuous noninvasive arterial pressure device with invasive measurements in cardiovascular postsurgical intensive care patients: a prospective observational study. Eur J Anaesthesiol. 2014; 32(1):20-8. DOI: 10.1097/EJA.0000000000000136. View

18.

Sun L, Wijeysundera D, Tait G, Beattie W . Association of intraoperative hypotension with acute kidney injury after elective noncardiac surgery. Anesthesiology. 2015; 123(3):515-23. DOI: 10.1097/ALN.0000000000000765. View

19.

Mayer J, Boldt J, Mengistu A, Rohm K, Suttner S . Goal-directed intraoperative therapy based on autocalibrated arterial pressure waveform analysis reduces hospital stay in high-risk surgical patients: a randomized, controlled trial. Crit Care. 2010; 14(1):R18. PMC: 2875533. DOI: 10.1186/cc8875. View

20.

Solus-Biguenet H, Fleyfel M, Tavernier B, Kipnis E, Onimus J, Robin E . Non-invasive prediction of fluid responsiveness during major hepatic surgery. Br J Anaesth. 2006; 97(6):808-16. DOI: 10.1093/bja/ael250. View